Patient safety

Leeds children’s heart surgery safe, Newcastle stoked safety fears – report

An independent review into children’s heart surgery at Leeds General Infirmary has found that the hospital’s heart unit is safe and provides excellent care, while also criticising doctors at a rival centre in Newcastle, who cast doubt on the quality and safety of the Leeds service at a time when the two were battling to avoid closure.

NHS England called in Verita, an independent investigative agency, to carry out the final reviews of the children’s heart unit at Leeds, which has been at the centre of controversy since NHS England data appeared to show that death rates among babies born with heart defects who needed complex surgery were higher than they should be. Surgery was temporarily shut down in April 2013 while investigations begun.

Adding to the alarm were comments from doctors and a letter sent from the chief executive at Newcastle’s Freeman Hospital to NHS England. Both hospitals had been reviewed as part of an attempt to rationalise children’s heart surgery in England and ensure surgeons operated on enough patients to remain expert in the difficult operations. Leeds was fighting against the closure of its unit, which would have meant most patients went to Newcastle instead, ensuring its survival.

But the reports released today have found that many of the claims made by Newcastle were untrue and driven by vested interest.

The Leeds campaigners who fought to keep their unit open, have welcomed the reports from Verita as the balanced investigation they had been waiting for.

Sharon Cheng, CEO, Children’s Heart Surgery Fund, said: “Verita’s analysis makes clear that many of the claims and accusations that led to the suspension of surgery and the subsequent unbearable scrutiny of the Leeds unit were unfounded or incorrect, and in some cases were made due to vested interests.  It is important to note that of the final 17 recommendations made, only one refers specifically to Leeds about communication. The rest are general points for all units.

“We understand the need to act on any concerns about healthcare provision in the UK.  However, the need for swift action should not negate the processes designed to ensure that concerns are valid and safeguard patients. We believe that NHS England has put new processes in place to ensure that this type of action, which is so damaging to patient and staff confidence, never happens again.  We would ask them to ensure that these processes are followed, without exception.”

The report also concluded that the ‘Safe and Sustainable’ cardiac review that initially looked at the units at Leeds General Infirmary and Newcastle’s Freeman hospital with a view to closures pitted units against each other and created a climate of fear.

Dr Mike Bewick, deputy medical director of NHS England, said: “Patients should be reassured that this service has been rigorously scrutinised and has improved as a result.  Patients and the public can have confidence that this is a well-run unit and is now in a position to go from strength to strength.

“Not only have we learned about service in Leeds we have learned lessons of relevance nationally. We are currently consulting on new standards for children’s heart surgery across the country and the review in Leeds has made a significant contribution.”

In September, NHS England has launched a new consultation paper on the future of children’s and adults’ congenital heart disease (CHD) services, in an attempt to move forward after a decade of debate over which hospitals’ surgical units should stay open and which should shut. That consultation closes on 8 December, and there are drop-in events coming up across England.

NHS England’s Specialised Commissioning Oversight Group said in a recent update on the CHD review: “’Safe and Sustainable’ took four years and had a net cost of £6m, but in the end the conclusions were not implemented because of concerns about the process. We are mindful of this and – despite the clamour for a quick solution – have resisted the temptation to take short-cuts in our process, our engagement or in our own internal assurance.”

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